Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial

Alexander Egle; Thomas Melchardt; Petra Obrtlíková; Lukáš Smolej; Tomáš Kozák; Michael Steurer; Johannes Andel; Sonja Burgstaller; Eva Mikušková; Liana Gercheva; Thomas Nösslinger; Tomáš Papajík; Miriam Ladická; Michael Girschikofsky; Mikuláš Hrubiško; Ulrich Jäger; Daniela Voskova; Martin Pecherstorfer; Eva Králiková; Christina Burcoveanu; Emil Spasov; Andreas Petzer; Georgi Mihaylov; Julian Raynov; Horst Oexle; August Zabernigg; Emília Flochová; Stanislav Palášthy; Olga Stehlíková; Michael Doubek; Petra Altenhofer; Lukas Weiss; Teresa Magnes; Lisa Pleyer; Anton Klingler; Jiří Mayer; Richard Greil

doi:10.1002/cam4.1980

Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial

Alexander Egle, Thomas Melchardt, Petra Obrtlíková, Lukáš Smolej, Tomáš Kozák, Michael Steurer, Johannes Andel, Sonja Burgstaller, Eva Mikušková, Liana Gercheva, Thomas Nösslinger, Tomáš Papajík, Miriam Ladická, Michael Girschikofsky, Mikuláš Hrubiško, Ulrich Jäger, Daniela Voskova, Martin Pecherstorfer, Eva Králiková, Christina BurcoveanuEmil Spasov, Andreas Petzer, Georgi Mihaylov, Julian Raynov, Horst Oexle, August Zabernigg, Emília Flochová, Stanislav Palášthy, Olga Stehlíková, Michael Doubek, Petra Altenhofer, Lukas Weiss, Teresa Magnes, Lisa Pleyer, Anton Klingler, Jiří Mayer, Richard Greil

Division of Internal Medicine 2 (University Hospital Krems)

Research output: Journal article (peer-reviewed) › Journal article

6 Citations (Scopus)

Abstract

No data are available regarding obesity and outcome in Chronic Lymphocytic Leukemia (CLL). We analyzed 263 patients from the AGMT CLL-8a Mabtenance trial for the impact of obesity. The trial included patients after rituximab-containing induction treatment in first or second line that had achieved at least a PR. A randomization to rituximab maintenance treatment (375 mg/m2 q3 months for 2 years) vs observation was performed. In this cohort 22% of the patients (58/263) were classified as obese. The baseline response to induction treatment was inferior in obese patients with a lower CR rate (43.1% vs 60.5% in obese vs non-obese, P = 0.018) and with a lower rate of patients achieving MRD negativity after chemoimmunotherapy induction treatment (19.6% vs 35.8%, P = 0.02). The PFS outcome of obese patients was significantly worse in the observation group of the trial (24 vs 39 months median PFS, P = 0.03). However, in the rituximab maintenance group the outcome for obese vs non-obese was not different (P = 0.4). In summary, obesity was overall associated with a worse outcome of chemoimmunotherapy induction. However, rituximab maintenance treatment seems to be able to overcome this negative effect.

Original language	English
Pages (from-to)	1401-1405
Number of pages	5
Journal	Cancer Medicine
Volume	8
Issue number	4
DOIs	https://doi.org/10.1002/cam4.1980
Publication status	Published - Apr 2019

Keywords

Adult
Aged
Aged, 80 and over
Female
Humans
Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
Maintenance Chemotherapy
Male
Middle Aged
Obesity/complications
Prognosis
Rituximab/administration & dosage
Survival Analysis
Treatment Outcome

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10.1002/cam4.1980

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Egle, A., Melchardt, T., Obrtlíková, P., Smolej, L., Kozák, T., Steurer, M., Andel, J., Burgstaller, S., Mikušková, E., Gercheva, L., Nösslinger, T., Papajík, T., Ladická, M., Girschikofsky, M., Hrubiško, M., Jäger, U., Voskova, D., Pecherstorfer, M., Králiková, E., ... Greil, R. (2019). Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial. Cancer Medicine, 8(4), 1401-1405. https://doi.org/10.1002/cam4.1980

@article{de48bf3bcce442aeab57935d9691aa28,

title = "Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial",

abstract = "No data are available regarding obesity and outcome in Chronic Lymphocytic Leukemia (CLL). We analyzed 263 patients from the AGMT CLL-8a Mabtenance trial for the impact of obesity. The trial included patients after rituximab-containing induction treatment in first or second line that had achieved at least a PR. A randomization to rituximab maintenance treatment (375 mg/m2 q3 months for 2 years) vs observation was performed. In this cohort 22% of the patients (58/263) were classified as obese. The baseline response to induction treatment was inferior in obese patients with a lower CR rate (43.1% vs 60.5% in obese vs non-obese, P = 0.018) and with a lower rate of patients achieving MRD negativity after chemoimmunotherapy induction treatment (19.6% vs 35.8%, P = 0.02). The PFS outcome of obese patients was significantly worse in the observation group of the trial (24 vs 39 months median PFS, P = 0.03). However, in the rituximab maintenance group the outcome for obese vs non-obese was not different (P = 0.4). In summary, obesity was overall associated with a worse outcome of chemoimmunotherapy induction. However, rituximab maintenance treatment seems to be able to overcome this negative effect.",

keywords = "Adult, Aged, Aged, 80 and over, Female, Humans, Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy, Maintenance Chemotherapy, Male, Middle Aged, Obesity/complications, Prognosis, Rituximab/administration & dosage, Survival Analysis, Treatment Outcome",

author = "Alexander Egle and Thomas Melchardt and Petra Obrtl{\'i}kov{\'a} and Luk{\'a}{\v s} Smolej and Tom{\'a}{\v s} Koz{\'a}k and Michael Steurer and Johannes Andel and Sonja Burgstaller and Eva Miku{\v s}kov{\'a} and Liana Gercheva and Thomas N{\"o}sslinger and Tom{\'a}{\v s} Papaj{\'i}k and Miriam Ladick{\'a} and Michael Girschikofsky and Mikul{\'a}{\v s} Hrubi{\v s}ko and Ulrich J{\"a}ger and Daniela Voskova and Martin Pecherstorfer and Eva Kr{\'a}likov{\'a} and Christina Burcoveanu and Emil Spasov and Andreas Petzer and Georgi Mihaylov and Julian Raynov and Horst Oexle and August Zabernigg and Em{\'i}lia Flochov{\'a} and Stanislav Pal{\'a}{\v s}thy and Olga Stehl{\'i}kov{\'a} and Michael Doubek and Petra Altenhofer and Lukas Weiss and Teresa Magnes and Lisa Pleyer and Anton Klingler and Ji{\v r}{\'i} Mayer and Richard Greil",

note = "Publisher Copyright: {\textcopyright} 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.",

year = "2019",

month = apr,

doi = "10.1002/cam4.1980",

language = "English",

volume = "8",

pages = "1401--1405",

journal = "Cancer Medicine",

issn = "2045-7634",

publisher = "John Wiley and Sons Ltd",

number = "4",

}

Egle, A, Melchardt, T, Obrtlíková, P, Smolej, L, Kozák, T, Steurer, M, Andel, J, Burgstaller, S, Mikušková, E, Gercheva, L, Nösslinger, T, Papajík, T, Ladická, M, Girschikofsky, M, Hrubiško, M, Jäger, U, Voskova, D, Pecherstorfer, M, Králiková, E, Burcoveanu, C, Spasov, E, Petzer, A, Mihaylov, G, Raynov, J, Oexle, H, Zabernigg, A, Flochová, E, Palášthy, S, Stehlíková, O, Doubek, M, Altenhofer, P, Weiss, L, Magnes, T, Pleyer, L, Klingler, A, Mayer, J & Greil, R 2019, 'Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial', Cancer Medicine, vol. 8, no. 4, pp. 1401-1405. https://doi.org/10.1002/cam4.1980

TY - JOUR

T1 - Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL

T2 - Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial

AU - Egle, Alexander

AU - Melchardt, Thomas

AU - Obrtlíková, Petra

AU - Smolej, Lukáš

AU - Kozák, Tomáš

AU - Steurer, Michael

AU - Andel, Johannes

AU - Burgstaller, Sonja

AU - Mikušková, Eva

AU - Gercheva, Liana

AU - Nösslinger, Thomas

AU - Papajík, Tomáš

AU - Ladická, Miriam

AU - Girschikofsky, Michael

AU - Hrubiško, Mikuláš

AU - Jäger, Ulrich

AU - Voskova, Daniela

AU - Pecherstorfer, Martin

AU - Králiková, Eva

AU - Burcoveanu, Christina

AU - Spasov, Emil

AU - Petzer, Andreas

AU - Mihaylov, Georgi

AU - Raynov, Julian

AU - Oexle, Horst

AU - Zabernigg, August

AU - Flochová, Emília

AU - Palášthy, Stanislav

AU - Stehlíková, Olga

AU - Doubek, Michael

AU - Altenhofer, Petra

AU - Weiss, Lukas

AU - Magnes, Teresa

AU - Pleyer, Lisa

AU - Klingler, Anton

AU - Mayer, Jiří

AU - Greil, Richard

PY - 2019/4

Y1 - 2019/4

N2 - No data are available regarding obesity and outcome in Chronic Lymphocytic Leukemia (CLL). We analyzed 263 patients from the AGMT CLL-8a Mabtenance trial for the impact of obesity. The trial included patients after rituximab-containing induction treatment in first or second line that had achieved at least a PR. A randomization to rituximab maintenance treatment (375 mg/m2 q3 months for 2 years) vs observation was performed. In this cohort 22% of the patients (58/263) were classified as obese. The baseline response to induction treatment was inferior in obese patients with a lower CR rate (43.1% vs 60.5% in obese vs non-obese, P = 0.018) and with a lower rate of patients achieving MRD negativity after chemoimmunotherapy induction treatment (19.6% vs 35.8%, P = 0.02). The PFS outcome of obese patients was significantly worse in the observation group of the trial (24 vs 39 months median PFS, P = 0.03). However, in the rituximab maintenance group the outcome for obese vs non-obese was not different (P = 0.4). In summary, obesity was overall associated with a worse outcome of chemoimmunotherapy induction. However, rituximab maintenance treatment seems to be able to overcome this negative effect.

AB - No data are available regarding obesity and outcome in Chronic Lymphocytic Leukemia (CLL). We analyzed 263 patients from the AGMT CLL-8a Mabtenance trial for the impact of obesity. The trial included patients after rituximab-containing induction treatment in first or second line that had achieved at least a PR. A randomization to rituximab maintenance treatment (375 mg/m2 q3 months for 2 years) vs observation was performed. In this cohort 22% of the patients (58/263) were classified as obese. The baseline response to induction treatment was inferior in obese patients with a lower CR rate (43.1% vs 60.5% in obese vs non-obese, P = 0.018) and with a lower rate of patients achieving MRD negativity after chemoimmunotherapy induction treatment (19.6% vs 35.8%, P = 0.02). The PFS outcome of obese patients was significantly worse in the observation group of the trial (24 vs 39 months median PFS, P = 0.03). However, in the rituximab maintenance group the outcome for obese vs non-obese was not different (P = 0.4). In summary, obesity was overall associated with a worse outcome of chemoimmunotherapy induction. However, rituximab maintenance treatment seems to be able to overcome this negative effect.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Humans

KW - Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy

KW - Maintenance Chemotherapy

KW - Male

KW - Middle Aged

KW - Obesity/complications

KW - Prognosis

KW - Rituximab/administration & dosage

KW - Survival Analysis

KW - Treatment Outcome

UR - http://www.scopus.com/inward/record.url?scp=85063087766&partnerID=8YFLogxK

U2 - 10.1002/cam4.1980

DO - 10.1002/cam4.1980

M3 - Journal article

C2 - 30888118

SN - 2045-7634

VL - 8

SP - 1401

EP - 1405

JO - Cancer Medicine

JF - Cancer Medicine

IS - 4

ER -

Rituximab maintenance overcomes the negative prognostic factor of obesity in CLL: Subgroup analysis of the international randomized AGMT CLL-8a mabtenance trial

Abstract

Keywords

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